Elections 6th May...

[organic]

Sarz - That's a cracking response.
It's got to be said, the LibDems do seem pretty positive on some big issues... though (as with any other policy I like) it always seems wrapped up with something I object to in equally strong terms.
IIRC the Dems are also quite strongly Europhile and easilly the firmest of the big-three when it comes to "doing something" about climate change... two things I just can't condone.
There is quite a lot I like about some of the LibDem policies, but being as they are still a fundamentally "statist" party I have issues.


Zazen...
Re: Ross Kemp - the "negatives" he held against the tories could just as easilly be held against labour - when governments meddle in the markets they break them. That leads to the massive swings of "boom and bust" - whoever is in power at the bottom of a bust will get those kind of criticisms and the absolute, concrete fact is that booms and busts happen - they are longer and worse when the markets are manipulated by politicians and any promise (as we've seen recently) to end that will come to nought.
The "positives" he held up for Labour can be summarised as follows:
More schools (more cost), more police on the streets (spending less time on the streets and more in the station ticking Labour's boxes - and more cost - all backed up with a completely ineffective justice system meaning the money spent on police is WASTED), billions invested in a health service for all (more cost and so much debt the investment is turning into cuts and so money WASTED - and private sector would do it cheaper and better - even if required to care for those on a low income) and a minimum wage that has increased the cost of goods and services right across the board, inflating prices meaning there is no real net gain for those at the bottom of the pay scale while making things even less affordable for those a wee bit further up the ladder.

BOTH of the above are caused by a government trying to do things that should be left to the individual, the private sector, contracts and the brutal reality of free markets.

If he votes for Labour -!!!!!!!!!!!!

More CCTV than ever before (usually inadmissable as evidence or even unchecked when a violent crime takes place right in front of one). ID cards and database. NHS spine. Religious Hatred Bill (as it was before it was neutered before becoming the Act). Legislative and Regulatory Reform Bill (aka The Abolition of Parliament Bill). Denial of the promised referendum on EU constitution (exactly what Lisbon is). Mental Capacity Act (regardless of your views on euthenasia that is one of the most horrendous pieces of legislation on the statute today). Moves to legitimise the monitoring of email, phone calls and text messages... and the list goes on.

People like Kemp, arguing the toss over services that will either be cut or will saddle yet another (as yet unborn) generation with a huge pile of debt they don't want or need... miss some of the most important issues of all... those concerning our very freedom and liberties.

To vote for a party that has done or attempted to do everything listed above truly is crazy.

As was written inside the cover of many of the copies of George Orwell's classic that was sent to the MPs not too long ago...

1984 was a warning - not an instruction manual!

[Two_Sheds]

billions invested in a health service for all ... private sector would do it cheaper and better

Please explain, in simple terms, how a private health service would provide health care for all, not just those who can afford it, bearing in mind that private businesses exist to make profit for shareholders: they don't exist to provide a service to the public (hence the axing of local train/bus services because they aren't profitable, and too many buses running on the profitable routes).

How could people on low or no incomes afford say, £20,000 for a course of chemotherapy?

Many people, myself included, no longer go to the dentist because a check-up alone costs £18, a private filling over £100.

[pigletwillie]

I think the point being made is it would be cheaper if the private sector could provide the NHS service in a more efficient and cheaper way but still at no cost to us at the point of use..

My sister in law has just had a hip replacement on the NHS but in a private hospital. It was outsourced at it is £700 cheaper than if done by the our local NHS trust.

As a free at point of use system the NHS must be ringfenced, how it is provided though could save lots in efficiencies and should be looked at.

[Two_Sheds]

Efficiencies and savings can always be made, in any organisation, I absolutely agree.

In the public sector, this usually means job cuts (or giving jobs to cheaper foreign labour, such as nurses from Nigeria, cleaners from Poland). I don't believe it's efficient to put people on the dole though. We still end up paying them, whether it's to work or to not work. Personally, I'd rather people were in meaningful work than lounging at home playing computer games.

There is also waste in the private sector, waste which has to be paid for by someone along the line.
In Mr TS's industry (as one example) I would stop the freebie 3 hour lunches, the free boxes at football matches, the free first class travel, the free petrol etc. Perhaps then the company could afford to employ a few more workers on the ground instead of giving a lavish lifestyle to the bosses at the top of the tree (we've heard through the grapevine that he's probably losing his job this week).

[kernowyon]

I think the point being made is it would be cheaper if the private sector could provide the NHS service in a more efficient and cheaper way but still at no cost to us at the point of use..

My sister in law has just had a hip replacement on the NHS but in a private hospital. It was outsourced at it is £700 cheaper than if done by the our local NHS trust.

we have outsourced hip ops in our trust, but when things go wrong and transfusions and high dependency beds etc are needed, where do they get that from, the NHS. when these patients have the op and are discharged most are refered back to the nhs for the aftercare such as physio. these company costs can be cheaper because they only provide a portion of the potential costs.

[organic]

Two_Sheds.

Two clear possibilities and one alternative... one would be something along the line of PW's take on it... but I have a sneaking feeling that would be too close to the current state of the "private" rail companies. They are private, for profit and all that... but they are absolutely not in any kind of free market or competing with eachother.
The example I've used before is "try getting a non-Virgin train direct from Manchester to London". It's still the same monopoly and yet the prices are sky high.


I feel Healthcare for those on incomes too low to afford their own healthcare would be better provided by charities and non-profits taking care of it -and if the savings made in moving from NHS to free-market hospitals were passed on to the public through massive tax cuts, the majority would have more disposable income - even after buying their health insurance - to voluntarily support healthcare for those who couldn't afford it without the compulsion or waste inherent in the current model. One possibile model for this would be like the one that currently supports the lifeboats. In fact, the RNLI model of operating on donations, spending on equipment and medication rather than on huge wages could possibly be the best option in this case.


But if for some reason people couldn't accept that kind of setup there's another really simple way of doing it.
On a means tested basis - require all hospitals to treat patients regardless of their ability to afford it. This would mean others had no choice but to pay for someone else's healthcare - and it's the liberty side of the free market approach that I like - but it would still provide healthcare for all in a competitive* environment without the waste that is inherent in nationalised healthcare due to lack of competition and zero risk of failure.


* competitive, in the case of medical treatment, means competing to have cleaner wards, shorter waiting lists, the most effective treatments, the most cutting edge surgeries and so on - all at a lower price than their competitors.
I've been looking into a treatment to correct a couple of teeth that have grown in the wrong way (you wouldn't know it to look at me)... on the NHS I have no choice but fixed appliances... which seriously don't look good (an issue when you're meeting clients face to face and already don't fit the usual "professional" stereotype) and must be fitted either inside, lacerating my tongue for a couple of years... outside, doing the same to my lips... but most likely both - which seriously does not appeal... nor does the inability to maintain proper oral hygeine with a fixed appliance in place or the masses of food stuck in it after every meal.

I popped into a private clinic to see about a treatment that needed no fixed appliance, was removable and can achieve the same result. They couldn't have been more helpful. They took me through the pros and cons of the treatment, explained the costs involved, how it works, and were happy to answer all the questions I wanted (some of which weren't even related) - giving me, free of charge, about 30 minutes with one of the dentists to answer some of the more technical ones - and generally left me with such a positive feeling about the whole thing I'm currently saving up the four-figure sum to get it done. A sum I'll only ever have to pay once... and only for myself. Long term it will be far cheaper this way.

If I'd seen my NHS dentist about it I'd have had to pay for the appointment (free at the point of use... remember?) would have been fobbod off snottily after the first couple of questions and quite frankly laughed out the door if I'd asked for this treatment over the ancient and painful one on offer.

NHS - if it achieves the end result and costs as little as possible - you can have it.
Private - if it achieves the end result with an aceptable impact on your way of life - you can have whatever you want.

Why the difference?
Because regardless of my experience or happiness - the NHS dentist knows he's got a job for life, a waiting list of people desparate to see him and really doesn't need to try to retain my custom... wheras the private practice knows beyond any doubt that I can go elsewhere, use other branded treatments of the same kind and they need to put the effort not to meet some target or other... but to pay the bills.

It's tough to get your head around the NHS being a bad thing and free market being far cheaper, efficient and possibly even just as (if not more) inclusive - but it really is.

[Two_Sheds]

the majority would have more disposable income - even after buying their health insurance - to voluntarily support healthcare for those who couldn't afford it

My problem with private health insurance (Mr TS has it) is that it doesn't cover you for existing problems. He has a family history of high blood pressure and heart problems. So, his health insurance won't cover him for those things. Fat lot of good that is.

... I'm sorry, I can't think of many people who would voluntarily fund someone else's healthcare.

on the NHS I have no choice but fixed appliances.

I completely agree with you that elective (cosmetic) surgery should be paid for privately.

The NHS should be for necessary health care, not cosmetic (I count burns/cancer plastic surgery as necessary, not cosmetic).

Out of interest, where do you stand on treatment for people who could be said to have brought the illness upon themselves, ie smokers who get lung cancer, drinkers who get cirrhosis?

[organic]

Next time you're in a land-locked city - have a look for cars sporting a "Support our lifeboats" sticker.
People with (usually) no direct connection to the sea, who don't go out on it, and yet not only happily support the RNLI but encourage others to do so.

You know plenty of people who would voluntarily fund the healthcare of others through charity donations... they are the exact same people who fund the work of Help the Heroes, the British Legion, the RSPCA, Help the Aged, Macmillan, and so on.

With more disposable income people would have more money available to voluntarily fund the healthcare of those who can't afford their own insurance or their own treatment if they decide not to bother with insurance (which is also a valid - if risky choice).

I don't believe for a minute that people with existing conditions wouldn't be able to get insurance - even if they can't now. Even private healthcare in this country isn't on a free market basis. If it was things would be very different.

Private insurance providers currently pick and choose their clients knowing the NHS will treat the rest. Were that not the case there would be competition to cover "high risk" people - just like there is competition to insure "high risk" drivers like 17 year olds with modified "street racer" type cars.

Even if they can't get insurance, I see no reason they shouldn't choose between living a healthy lifestyle that reduced their risk of developing the same diseases as their family had - and if they can't get insurance for those illnesses - recieiving charity funding for treatment of the same.

Oh and for the record...
...I've got family history of alzheimer's, heart disease and cancer... just in case anyone thinks of suggesting it's easy to talk like this when you're not the one at risk. I am.


Whether or not the NHS should fund "cosmetic" surgery (and what I'm talking about is not cosmetic at all - it's problematic but I won't go with the NHS's medieval torture device treatment as "the cure is worse than the illness" with those things) doesn't come into it. The point wasn't the treatment - but the fact that private gives you good service and decent choices tailored to the individual whereas the NHS gives you prehistoric treatments that are really unpleasant while the treatment is ongoing and wastes a fortune in the process.
Bad service, no real choice and far more expensive than it needs to be.


I don't believe anyone should be forced to pay for someone else's medical treatment regardless of how it comes about... and I include drinkers and smokers in that.

You make choices and should be prepared for the consequences.

I go snowboarding in France every chance I get (and lived in Chamonix for a while so I've done it a hell of a lot).
If I get hurt the net cost to the taxpayer is zero.
I carry private insurance which covers getting me off the mountain, into hospital and back to health. If I go without it I'll have to hand over a credit card before they'll even get me off the hill.
I see no problem with that whatsoever.

My choice, my responsibility.

[Two_Sheds]

the NHS gives you prehistoric treatments that are really unpleasant

In your case, perhaps.

I've just come back from visiting FiL in hospital: his life has just been saved, actually, by the NHS. His treatment has been considerate, humane, friendly and personal.

...and while I was being treated for cancer (back in the Tory reign) and while the cleaning & catering left much to be desired, I was given every possible treatment - the triple whammy of surgery, radio & chemo: no expense was spared. I was even offered new teeth & further plastic surgery worth £15,000+, but I declined. I felt I'd already taken my fair share from a health service that I'd not long been paying into.

btw, my plastic surgeon also does lucrative private work, so I completely trust his expertise.

[Alison]

Have avoided this thread for a few days and having just caught up on it am truely amazed by some of the views being put forwards. Whilst certainly not perfect I am incredibly proud of the fact that we have the NHS in this country and that if ever I have the misfortune to have a heart attack in the street I will be cared for, no questions about insurance etc asked. There are obvious exceptions but on the whole the treatment is excellent. My mum had a cyst the size of a rugby ball removed from her abdomen last year which was spotted by an excellent doctor from a seemingly unrelated symptom. The operation was a big one for anybody but the care my mother in her mid 70s received was second to none and, it being an important operation, was swift and timely.

Re the charity thing, yes, we give to the RNLI, think it's a couple of quid a month which gives us the right to have a sticker in the back window but not really anything like enough to fund a worthwhile and ethically motivated health service.............

[organic]

That's one example.
There's the medications the NHS won't fund... medications they'll only fund in some areas... but none of this is the point.

The point is that the NHS, whether a course of treatment is cutting edge or from a darker time, costs more money than would a healthcare system exposed to the free market. Because it is a monopoly which will recieve whatever funding it needs there is no risk of failure. Competition makes for cheaper and better service all round.

I'm not saying the NHS doesn't save lives. It does.

The point is that the NHS, while it basically works, is bloated, expensive and wasteful. The competition inherent in a free market healthcare model would provide the same (or better) services and standard of care for a lower overall and individual cost.

People will want to see clean hospitals, the best treatments and the lowest prices. Competition will see people going to the cleanest, best hospitals and the others will be forced to clean up their act and improve their quality of care.


Just as one example of the wastefulness of the NHS.
In 2002 it was reported that calls to NHS Direct cost the taxpayer an average of £18. The average GP visit cost the taxpayer £14.
Added to that, 80% of the nurses staffing the service had left other posts to do so leaving the hospitals themselves short staffed.
NHS Direct was set up to take pressure off GP surgeries and hospital A&E - and yet it left hospitals short of nurses and cost us all MORE money.

As if that wasn't enough, the service contributed to a rise in GP out-calls and demand in A&E.

Fun eh? A more expensive service which actually increased the pressure on the two areas it was supposed to relieve it.

Such is the chronic waste inherent in nationalised healthcare.

I saw an article a while back which stated that the average family in England spent £4,500 on the NHS in 2009.
Over a lifetime that comes to a massive amount of money and the vast majority of us will never get our money's worth. Even those of us who suffer from an illness or injury needing fairly expensive care are usually out of pocket over a lifetime.
Think about it.

In 10 years the average English family will have spent £45,000 on the NHS... if the average family has kids living at home for a total of 25 years that's £112,500 of NHS costs just for that time period, and considering that for most of that time the parents will be paying the whole of that cost you can extrapolate that to a person's working life and get a very rough cost, per couple, of about £210,000.

When you look at that, the £20,000 course of chemotherapy you mentioned earlier (if that is indeed what it might cost) is a drop in the ocean.

Free healthcare costs us an absolute fortune.

Even if those numbers aren't accurate and we HALF them - it still doesn't make sense to have a nationalise monopoly healthservice costing us that much money when a free market, competitive model would be at least as good and far cheaper. Competitive markets drive down prices - compare the price of a flight from Manchester to Dublin 20 years ago with the price of the exact same flight post-deregulation - the reduction is something like 90% - even if you buy the overpriced in-flight food and drink. The same is not true on the railways or most bus routes where monopolies and occasionally duopolies are the norm... nor is it the case in the NHS... in all of those areas prices are rising massively and would be brought down in a similar way if they were exposed to market forces.

That's the whole point - not whether the NHS helps people or does a good job - but that it's wasteful and should be replaced with a private, free market model supported by charities for those who simply can't afford it - and supported they would be... especially with "the average family" £4,500 better off every year through removal of the NHS burden.

[Alison]

I have no idea whether your figures are accurate or not but I'm perfectly happy to pay in over my working life. I also pay for education for children I will never bear but again I'm not so selfish as to object as I can see the greater good. As I've already said, it's not a perfect system but to privatise it would mean that the key aim would be profit rather than health care which is fundamentally wrong and something I would fight all the way. It's not essential for me to get a cheap flight to Dublin but it is essential for somebody to get treatment when they most need it and not to add the further worry of the financing of that treatment. Organic, you keep quoting the "average family" that means there are many above and below this line. Maybe you have had bad experiences but it is a shame you are so bitter about it all and just look at things in a financial way. It is interesting to note that at the very start of the NHS, it uncovered vast amounts of previously ignored illnesses from the poorer areas of society who had quite simply not been able to afford treatment in the past. To go back to that scenario would be a terrible thing.

On a similar note, it is also interesting to point out that some of the Scandanavian countries have far higher taxation than us but tend to score very highly on the quality of life measures - which by the way cover far more than personal weath as there is far more to happiness than that.

[organic]

Alison - yes, the NHS do good work, but it costs us a disgusting amount of money. A private model would be at least as effective and cost less.

The RNLI may be a couple of quid a month but if taxation was cut by the £100,000,000,000-ish that the NHS costs us annually the saving would be immense and leave people considerably better off... better able to afford decent donations to a charity which funds healthcare for those incapable of working.

Oh and that "couple of quid" to the RNLI is supplemented by donations via wills, fundraisers and so on. They manage to raise about £140,000,000 a year even with people struggling under an ever-increasing tax burden and an overpriced NHS.


Finally, the old myth of being refused help in the case of an emergency is just that. A myth. Even in America - that country so slated for its lack of nationalised healthcare (even though it has it at great cost) and refusal to treat heart attack victims who aren't insured - heart attack victims who aren't insured are not turned away or asked about insurance. They are treated regardless. If they are insured the insurance will pay up. If they aren't then they will pay up.

Either way they'll pay less for that treatment than it would have cost them if they paid for it throughout their working life in the "free" NHS.

[Alison]

I am never going to agree with you on this one Organic and you are never going to answer many of the challenges which have been put to you by a variety of people on this thread. Obviously you're entitled to your view but to be honest, it's been a long day and I don't have the energy to read through your rather long winded posts (it's been a long day and it's only Monday!) to discuss further so will leave you to it. Am however more than glad that none of the main parties are supporting your views as I wouldn't want to live in that world.

[organic]

I am not looking at this in a purely financial way... but let's stick with that for a moment.

You've brought up this long standing concept of profit being some kinf of immoral aim. The NHS is absolutely for profit. Do you think the surgeons, doctors, porters, nurses and so on are working voluntarily?

Even that aside - what's so bad about profit?

1> Non-profit monopoly, costs the taxpayer a dirty great big pile of money, does and OK job most of the time.
2> Competitive market, for profit, overall costs far less even though (through charity or compulsion) it cares for those who can't afford it and provides a standard of care at least as good - if not better than the monopoly.

Profit is exactly what has given us the standard of living we enjoy today.

Profit drove the invention and commercial development of the bicycle, the motorbike and the motorcar. Profit drives the vast majority of the advances in healthcare that have extended our life expectencies from 40 to fast approaching 100 in just a few generations. Profit has driven the massive increase in recreational time we have available when compared to the long and gruelling working days endured by all and sundry further back still.

Profit is not a bad thing and exposing healthcare to market forces and profit would do nothing but reduce costs to the user and increase efficiency. That's just how markets work.

Markets used to be happy with oily cars that broke down all the time... then they demanded safer, cleaner and more reliable cars and we now have silent running, emission free fuel cell cars coming over the horizon.

Profit and market forces are not some unethical thing to be fought against - they are THE reason life in this country is as good as it is.

If, from everything I've been saying, you genuinely think I want to go back to a time where the poor couldn't get treatment you clearly haven't been reading with an open mind.

There is no reason whatsoever that the kind of system I'm proposing would exclude the poorest. In fact it would be trivial to require it to accept them.

The thing you must remember is that at the start of the NHS people were, on the whole, far worse off (financially) than we are now. We have almost unimaginable wealth compared to previous generations. Trying to claim that a new healthcare model (and it would be new - not the old system) would be a return to those times is at best mistaken.